Irregular Menses

Every month, the body prepares itself for pregnancy. The cycle starts with the thickening of the uterine lining, followed by the growth of an egg. The egg is released from the ovary, and if there is sperm present at that time in the fallopian tube, then it will fertilise the egg. The embryo formed will then come and implant in the uterine lining. If there is no pregnancy, then the uterine lining will shed, and menstrual blood along with uterine tissues will flow out from the vagina. This is called menstruation.

What are irregular menses?

A menstrual cycle is normal vaginal bleeding that happens as a part of a woman’s monthly cycle. Every woman is different and every woman’s period cycle is different, for some it is like clockwork, and for some, it may come early or late So, the length of the cycle can range from 21 days to 35 days, the average duration of the cycle is 28 days. A menstrual period usually lasts for 4 to 7 days.

But there may be some women for whom the length of the cycle may exceed 35 days. This means the menstruation cycle is not regular, and a woman has irregular menses. So, an irregular period is any cycle that would drift away from its monthly cycle, that means the length of the menstrual cycle would keep changing.

What are the possible symptoms of irregular menses?

The symptoms of irregular periods, also called Oligomenorrhea, are:

  • When the length of menses is less than 21 days or more than 35 days.
  • If there is a change in blood flow, that is when the bleeding is too heavy or light, or if a long clot appears, then it is considered as irregular.
  • If periods last more than seven days.
  • Severe cramping, discomfort, nausea and vomiting during the time of periods.
  • Three or more missed periods.

What are the causes of irregular menses?

Many factors can increase the chances of irregular menstruation, and the most common being a hormonal imbalance. The two hormones that regulate the menstrual cycle are oestrogen and progesterone, and their imbalance can disrupt the menstrual cycle. Other possible causes are:

  • Stress or anxiety – Getting stressed out on any problem, be it big or small can upset your hormonal balance causing a missed period or an irregular cycle.
  • Poor diet – A poor diet that is low in nutrients, antioxidants and probiotic foods can strain the adrenal and thyroid glands, and this can raise the level of cortisol in your body (a hormone that is released at the time of stress). And this resulting cortisol imbalance leads to changes in oestrogen and progesterone, thus disrupting the menstrual cycle.
  • Eating disorders – Eating disorders like Anorexia and Bulimia has been linked with low levels of reproductive hormones, which causes irregular menses.
  • Extreme weight loss or gain – Sudden weight gain or weight loss affects the regularity of menses as it affects the functioning of hormones.
  • Too much exercise/running/cycling – Menstrual cycle is dependent on body fat and hormonal balance. And exercising too much can result in weight loss, thus causing a shift in hormonal imbalance.
  • Using birth control pills or having an intrauterine device – Birth control pills or IUD’s can make periods lighter, cause missed periods, or less or more frequent periods and even no periods at all.
  • Some medications/anticoagulants – Some antipsychotics, antidepressants can cause irregular periods, and anticoagulants (blood thinners) like heparin and warfarin can make periods heavier.
  • Bleeding disorders – If a woman has bleeding disorders like platelet disorders, clotting factor deficiency, then it can cause prolonged or heavy bleeding.
  • Hyperthyroidism or hypothyroidism – A thyroid disorder can cause irregular periods. The body’s metabolism is affected by the hormone produced by the thyroid gland.
  • Hyperprolactinemia – in hyperprolactinemia (increased prolactin level) menstrual disorders like irregular bleeding, insufficient luteal phase, anovulatory cycle and amenorrhoea are common.
  • Pelvic Inflammatory disease – A woman who has pelvic inflammatory disease might experience irregular menstrual periods, long periods and spotting or cramps throughout the month.
  • Polycystic Ovary Syndrome – A woman with PCOS does not ovulate, so an egg does not release every month. So, the chances of irregular periods or no periods increases.
  • Uterine Fibroids – A woman with uterine fibroids if symptomatic can experience heavy bleeding, irregular bleeding or painful periods.
  • Endometriosis – If a woman has endometriosis, she will most probably suffer from irregular periods because the lining of the endometrium is shed every month during menstruation. But in this case, the lining is found outside the uterus.
  • Cancerous growth within the uterus, cervix and ovaries – In rare cases, these can cause bleeding in between periods or during sexual intercourse.
Getting pregnant with irregular menstrual cycle

Irregular periods (oligomenorrhoea), missed periods (amenorrhoea) or abnormal bleeding might indicate that there is a problem with ovulation. And in the absence of ovulation, it would difficult to get pregnant Hormonal medication, or fertility treatments may be recommended if a woman is not able to get pregnant naturally.

What is the treatment option for irregular periods?

  • It is advisable to consult a doctor if any symptom of irregular periods is noticed. The treatment would be based on the cause of the symptom.
  • Medications – if the reason for irregular periods is due to hormonal imbalance, then the doctor may prescribe drugs or hormonal therapy to regulate the menstrual cycle.
  • Stress – If the cause of irregular menses is due to stress, then it is advisable to remain stress-free, as this will help to regulate the hormones, and this, in turn, will control the menstrual cycle.
  • Underlying Diseases – If irregular menses are due to any disease or underlying bleeding disorders, then the doctor will first treat the primary disease, and then see its impact on the menstrual cycle.
  • Surgery – If irregular periods are caused by fallopian tube blockage or some structural problem in the uterus like uterine fibroids, then they can be removed through surgery to regulate the menstrual cycle.
  • Lifestyle changes – A woman should attain a healthy weight, maintain a healthy lifestyle, quit smoking and restrict excessive alcohol consumption, eat healthy food and exercise, which can be beneficial in regulating the menstrual cycle.

Related questions on irregular menses: –

Q1) Does irregular periods mean infertility?

A) Irregular or abnormal ovulation accounts for 30 – 40 % of all cases of female infertility. If a woman is having irregular periods, no periods or unusual bleeding, then it is an indication that she is not ovulating (anovulation). In this case, without the help of fertility treatment, it is not possible to conceive, thus causing infertility.

Q2) Are irregular periods normal?

A) Having irregular periods may always not pose a problem and maybe normal in some of the cases like puberty, pregnancy, menopause, intake of birth control pills, IUD’s. But if there are some severe health complications associated with it, then it is advisable to visit a doctor at the earliest.

Q3) Can irregular periods cause weight gain?

A) Irregular periods due to polycystic ovary syndrome can cause weight gain.

Q4) Are periods irregular after having a baby?

A) After pregnancy, many women say that they have changes in their period cycle; it takes time for the cycle to get regulated. Women who breastfeed, may not have periods till the time they feed the baby.

Q5) Can you get pregnant if you have irregular periods?

A) If irregular periods are due to ovulation problem, then a woman might need fertility drugs or fertility treatment to get pregnant.